Mentions:
CAA is significantly associated with lobar intracerebral hemorrhage (ICH) (Figure 4A), but not with deep ICH,19 because sporadic Aβ-type CAA is commonly found in the meningeal and cortical vessels of cerebral and cerebellar cortices, and rarely in those of the deep gray matter including basal ganglia, thalamus, and brainstem.6 Using the SMASH-U system (structural lesion, medication, amyloid angiopathy, systemic/other disease, hypertension, undetermined) as a pathogenetic classification system for ICH, CAA-related ICH was noted in 20% of ICH cases in the Helsinki ICH study,20 and 12% of ICH cases in the National Taiwan University Hospital Stroke Registry.21 CAA-related ICH was the second most common cause of ICH following hypertensive angiopathy in these studies.20,21 The incidence of lobar ICH in the elderly has been increasing recently, in which CAA is strongly implicated.22 CAA-related lobar ICH is often multiple and recurrent, and clinical manifestations include motor paresis, disturbance of consciousness, abnormalities in higher brain functions, such as aphasia, visual loss, with headache at the acute stage, and dementia and seizures during chronic stages.9 Headache with meningeal signs is likely caused by subarachnoid hemorrhage (SAH) accompanying lobar ICH.23,24,25

Mentions:
CAA is significantly associated with lobar intracerebral hemorrhage (ICH) (Figure 4A), but not with deep ICH,19 because sporadic Aβ-type CAA is commonly found in the meningeal and cortical vessels of cerebral and cerebellar cortices, and rarely in those of the deep gray matter including basal ganglia, thalamus, and brainstem.6 Using the SMASH-U system (structural lesion, medication, amyloid angiopathy, systemic/other disease, hypertension, undetermined) as a pathogenetic classification system for ICH, CAA-related ICH was noted in 20% of ICH cases in the Helsinki ICH study,20 and 12% of ICH cases in the National Taiwan University Hospital Stroke Registry.21 CAA-related ICH was the second most common cause of ICH following hypertensive angiopathy in these studies.20,21 The incidence of lobar ICH in the elderly has been increasing recently, in which CAA is strongly implicated.22 CAA-related lobar ICH is often multiple and recurrent, and clinical manifestations include motor paresis, disturbance of consciousness, abnormalities in higher brain functions, such as aphasia, visual loss, with headache at the acute stage, and dementia and seizures during chronic stages.9 Headache with meningeal signs is likely caused by subarachnoid hemorrhage (SAH) accompanying lobar ICH.23,24,25